Tell us more about the deal, your background & why you need this loan?

Co-borrower Information

First Name

Last Name

Email Address

Home Phone

Cell Phone

Fax

Mobile Service Provider

Same as borrowers address?

Address

City

State

Zip Code

Rent or Own

Length of time at address

Has the borrower resided at the present address for less than two years?

Yes No

Previous Address

Previous City

Previous State

Previous Zip Code

Rent or Own

Mailing Address

Same as borrowers mailing address?

Mailing Address

Mailing City

Mailing State

Mailing Zip

Personal Info

Date Of Birth

Place Of Birth

Social Security Number

Driver License State

Driver License Number

Marital Status?

Unmarried Married Separated

Married to Borrower?

Yes No

Citizenship

U.S. Citizen Perm Resident Alien Non-Perm Resident Alien

Equifax Score

Mid Fico Score

Transunion Score

Experian Score

Credit Score Range

Business Entity

General Business Info

Entity Name

Trade Name/DBA

Entity Type

Date Of Formation

Time in Business

State Of Formation

States Registered In

Federal Tax ID/EIN

Organizational Ref #

Business Phone

Website Address

Business Address

Start Date at Location

Address

City

State

Zip Code

Is the billing address the same as above?

Billing Address

Billing City

Billing State

Billing Zip Code

Location

Urban Rural Suburban

Property Ownership

Value of Property?

$

Total Debt on Property?

$

Name of Lender(s)?

Landlord/Mortgage Contact Name

Landlord/Mortgage Phone

Rent/Mortgage Payment

Business Details

Business Type

# of employees currently

# of employees after loan

Business Category

Type of product or service sold

Naics Code

NAICS Code look up

Does your business sell a

Service Product

Is your Business

B2B B2C

Is your business home based?

Yes No

Do you take credit card payments?

Yes No

Terminal/ POS Make/Model

How many card processor banks do you have active?

Merchant Processing Bank Name(s)

Do you charge sales tax?

Yes No

How are employees paid?

Do you have more than one business location?

Yes No

How many locations?

Other Location Details & Addresses

Is the business a franchise?

Yes No

Name of Franchise

Point of Contact

Point of Contact Phone

Point of Contact E-mail

Website for Franchise

is your business seasonal?

Yes No

if Yes, what are the peak months?

Business Description

Do you have Business Reference(s)?

Yes No

1) Business Reference Name

Phone Name

Company

Fax

Email

Business Financials

Average Monthly Credit Card Sales

Average Monthly Deposits

Annual Revenue

Annual Gross Profit

YTD-Net Business Income

Date of Operating Agreement

Gross Annual Revenues $

$

Gross Income Last Year

$

Net Income Last Year

$

Gross Income 2 years ago

$

Net Income 2 years Ago

$

Average Bank Balance

$

Has business ever filed for bankruptcy?

Yes No

Status of Business Bankruptcy

Recent NSFs

Does your business owe taxes for years prior to the current year?

Yes No

Corporate Secretary Name

Notes

Sales Method

Retail Swiped

%

KEYED

%

ECOMM

%

MOTO

%

Fee Schedule

Visa/MasterCard/Discover/AXP Qualified Credit Card Discount Rate(for Tiered/Flat) %

%

Visa/MasterCard/Discover/AXP Qualified Credit Card Pass Thru I/C Plus

Qualified Check Card Discount Rate (for Tiered/Flat)

%

Qualified Check Card PassThru I/C Plus

Visa/MasterCard/Discover/AXP

$

Authorization Fee

$

Monthly Program Fee "Cash Discount"

$

Customer Service Fee

$

Monthly Minimum Fee

$

PIN Debit Transaction Fee

$

Batch Fee

$

Amex OPT Blue Qualified Rate

%

Amex OPT Blue Mid Qual

%

Amex OPT Blue Non Qual

%

Amex OPT Blue Pass Thru I/C Plus

Amex ESA #

AVS Transaction Fee

$

EBT Transaction Fee

$

EBT Account#

Amex Processing Fee

%

Other Fee

$

3 Tier Pricing Visa/MC/Disc/AXP Mid Qual

%

3 Tier Pricing Visa/MC/Disc/AXP Non Qual

%

Chargeback Fee

$

ACH Retrieval Fee

$

Equipment Info

Are you currently using a point of sale system?

Yes No

Software

Software Version

Additional Guarantors

Are there any additional guarantors?

Yes No

First Name

Middle Name

Last Name

Phone #

Cell

SSN

Date Of Birth

Marital Status?

Address

City

State

Zip

Email

Citizenship

U.S. Citizen Perm Resident Alien Non-Perm Resident Alien

Guarantor Notes

General Guarantor Notes

HMDA - (Borrower)

HMDA - (Co-Borrower)

Borrower Background

Are you a U.S. Citizen?

Yes No

Origin

Visa Status

Co-borrower Background

Are you a U.S. Citizen?

Yes No

Origin

Visa Status

Borrower Experience

Does borrower have Fix & Flip or Buy & Hold experience?

Yes No

# of years of experience?

# of properties completed in last 36 months

List 3 examples of past deals:

Property Type
Purchase date

Purchase Price

Amount Financed

Rehab Budget

Entity Name

Ownership %

Exit

Address
City
State
Zip

Upload HUD

Property Type
Purchase date

Purchase Price

Amount Financed

Rehab Budget

Entity Name

Ownership %

Exit

Address
City
State
Zip

Upload HUD

Property Type
Purchase date

Purchase Price

Amount Financed

Rehab Budget

Entity Name

Ownership %

Exit

Address
City
State
Zip

Upload HUD

Does borrower have ground up construction experience?

Yes No

# of years experience?

# of properties completed in last 36 months

List 3 examples of past deals:

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Entity Name

Ownership %

Exit

Monthly Rent

Sale Price

Sale Date

Address

City

State

Zip

Outcome/Profit

Upload HUD

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Entity Name

Ownership %

Exit

Monthly Rent

Sale Price

Sale Date

Address

City

State

Zip

Outcome/Profit

Upload HUD

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Entity Name

Ownership %

Exit

Monthly Rent

Sale Price

Sale Date

Address

City

State

Zip

Outcome/Profit

Upload HUD

Are you a builder/developer?

Yes No

Do you have a GC on staff, or do you hire a third-party GC to complete rehab/construction?

Yes No

Does borrower have experience selling properties without construction (e.g., wholesaling)?

Yes No

# of years experience?

# of properties completed in last 36 months

List 3 examples of past deals:

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Entity Name

Ownership %

Exit

Address

City

State

Zip

Upload HUD

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Entity Name

Ownership %

Exit

Address

City

State

Zip

Upload HUD

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Entity Name

Ownership %

Exit

Address

City

State

Zip

Upload HUD

Does borrower have any projects currently in progress?

Yes No

How many?

Does borrower own investment properties?

Yes No

How many?

Is borrower a member of an investment club or group?

Yes No

Name of Group/Club?

Do you have any professional licenses?

Yes No

Select Professional license

License #

Are you a full time real estate investor?

Yes No

How much liquid assets does borrower currently have?

Primary investment strategy

Describe Your Overall Real Estate Investment Experience

Primary investment strategy Explain

Typical Transactions

Amount of financing requested

$

To

$

Typical purchase price

$

To

$

Typical construction costs

$

To

$

Typical sale price

$

To

$

No. of construction draws per project

To

Months from purchase date to first construction draw

To

Months from purchase date until construction complete

To

Months from purchase date to sale date

To

No. of such projects that you will do at time

To

In which geographic areas do you intend to focus on the next 12-24 months?

Co-borrower Experience

Property Management

SBA Questions

Average Monthly Payroll of all employees?

$

Payroll Loan Amount:

$

Purpose of the loan:

Payroll Rent/Mortgage Interest Utilities Other

Is the Applicant (if an individual) or any individual owning 20% or more of the equity of the Applicant subject to an indictment, criminal information, arraignment, or other means by which formal criminal charges are brought in any jurisdiction, or presently incarcerated, or on probation or parole?

Yes No

Detailed Explanation

Have you been arrested in the past six months for any criminal offense?

Yes No

Detailed Explanation

Within the last 5 years, for any felony, has the Applicant (if an individual) or any owner of the Applicant 1) been convicted; 2) pleaded guilty; 3) pleaded nolo contendere; 4) been placed on pretrial diversion; or 5) been placed on any form of parole or probation (including probation before judgement)?

Yes No

Detailed Explanation

Has an application for the loan you are applying for now ever been submitted to SBA or to a Certified Development Company or lender in connection with any SBA program?

Yes No

Detailed Explanation

Is the Applicant a franchise that is listed in the SBAs Franchise Directory?

Yes No

Detailed Explanation

Does the Small Business Applicant have any Affiliates?

Yes No

Detailed Explanation

Has the Small Business Applicant and/or its Affiliates ever filed for bankruptcy protection?

Yes No

Status of Business Bankruptcy

Detailed Explanation

Is the Small Business Applicant and/or its Affiliates presently involved in any pending legal action?

Yes No

Detailed Explanation

Is the Applicant or any owner of the Applicant presently suspended, debarred, proposed for debarment, declared ineligible, voluntarily excluded from participation in this transaction by any Federal department or agency, or presently involved in any bankruptcy?

Yes No

Detailed Explanation

If you are at least a 50% or more owner of the applicant business, are you more than 60 days delinquent on any obligation to pay child support arising under an administrative order, court order, repayment agreement between the holder and a custodial parent, or repayment agreement between the holder and a state agency providing child support enforcement services? .

Yes No

Detailed Explanation

Has the Small Business Applicant and/or its Affiliates ever obtained a direct or guaranteed loan from SBA or any other Federal agency or been a guarantor on such a loan?

Yes No

Is any of the financing currently delinquent?

Yes No

Detailed Explanation

Did any of this financing ever default and cause a loss to the Government?

Yes No

Detailed Explanation

Are any of the Small Business Applicants products and/or services exported or is there a plan to begin exporting as a result of this loan?

Yes No

Provide the estimated total export sales this loan will support:

$

Is the Small Business Applicant using (or intending to use) a packager, broker, accountant, lawyer, etc. to assist in (a) preparing the loan application or any related materials and/or (b) referring the loan to the lender?

Yes No

Detailed Explanation

Are any of the Small Business Applicants revenues derived from gambling, loan packaging, or from the sale of products or services, or the presentation of any depiction, displays or live performances, of a prurient sexual nature?

Yes No

Detailed Explanation

No SBA employee, or the household member (see definition on page 1) of an SBA employee, is a sole proprietor, partner officer, director, or stockholder with a 10 percent or more interest, of the Applicant.

Yes No

Detailed Explanation

No former SBA employee, who has been separated from SBA for less than one year prior to the request for financial assistance, is an employee, owner, partner, attorney, agent, owner of stock, officer, director, creditor or debtor of the Applicant.

Yes No

Detailed Explanation

No member of Congress, or an appointed official or employee of the legislative or judicial branch of the Federal Government, is a sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest, or household member of such individual, of the Applicant.

Yes No

Detailed Explanation

No Government employee having a grade of at least GS-13 or higher is a sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest, or a household member of such individual, of the Applicant

Yes No

Detailed Explanation

No member or employee of a Small Business Advisory Council or a SCORE volunteer is a sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest, or a household member of such individual, of the Applicant.

Yes No

Detailed Explanation

Have you, or any business you controlled, ever filed for bankruptcy protection?

Yes No

Detailed Explanation

Is the United States the principal place of residence for all employees of the Applicant included in the Applicants payroll calculation above?

Yes No

Detailed Explanation

Do any of your employees earn more than $100,000/year?

Yes No

If Yes, Did you calculate your estimated monthly payroll using the cap of 100,000 per employee?
Detailed Explanation

Has the Applicant, any owner of the Applicant, or any business owned or controlled by any of them, ever obtained a direct or guaranteed loan from SBA or any other Federal agency that is currently delinquent or has defaulted in the last 7 years and caused a loss to the government?

Yes No

Detailed Explanation

Are you, or any business you control, presently involved in any legal action (including divorce)?

Yes No

Detailed Explanation

Has the Business received an SBA Economic Injury Disaster Loan between January 31, 2020 and April 3, 2020?

Yes No

Loan Amount

$

Detailed Explanation

Is the Applicant or any owner of the Applicant Business an owner of any other business/affiliate, or have common management with, any other business/affiliate?

Yes No

Detailed Explanation

Other Business/Affiliate Information

Company Name

Tax Id/EIN #

Legal Owners/Title/Ownership %

# of employees

Years in Business

Has applied for SBA loans?

Yes No

Description

Assets (Include Borrower + Co-borrower amounts if any)

Type

Estimated Value ($)

Amount Owed ($)

Cash

$

Checking Account(s)

$

Savings/Money Market/ CDs

$

Net worth of business(es) owned

$

Accounts & Notes Receivable

$

Stocks/Bonds

$

Non-Marketable Securities

$

IRA / Keogh Accounts

$

401k / ESOP Accounts

$

Life Insurance -- Cash Surrender Value Only

$

Total cash in bank accounts

$

Total value of retirement accounts

$

Availability under lines of credit

$

Home

$

Secondary Residences

$

Other Real Estate

$

Cars

$

Other Personal Property

$

Other Assets

$

Notes Payable to Banks & Others

$

Installment Account(s)

$

Revolving Debt

$

Unpaid/Payable Taxes

$

Secured Notes Payable to this Bank

$

Unsecured Notes Payable to this Bank

$

Accounts Payable (including credit cards)

$

Margin Accounts

$

Other Liabilities Owed

$

Other Assets Details

Other Liability Details

Unpaid Taxes Details

Total:

$

Total Est. Value

- Total Amt Owed

= Total Net Worth

$

- $

= $

Gifts or Grants

Gifts Or Grants : 1

Asset Type

Deposited/Not Deposited

Yes No NA

Source

Cash Or Market Value

$

Add Gifts Or Grants Info

Contingent Liabilities

Contingent Liabilities 1

Type Of Liability

Name of Company/Creditor

Monthly Payment

$

Months left to Pay

Balance/Amount

$

Account No

Description

Add New Contingent Liabilities

Schedule of Real Estate Owned and Sold

Schedule of Real Estate Info : 1

Property Address

Property Unit#

Property City

Property State

Property Zip

Property Country

Status

Ownership %

%

Type Of Property

Investment Type

Present Market Value

Balance of Mortgages & Liens

Gross Rental Income

Mortgage Payments

Insurance, Taxes, HOA (If Not Included in Payment)

Net Rental Income

Titled Under

Date Purchased

Purchase Price

Value of Improvements Made

Intended Occupancy

Are there any mortgages or liens?

Yes No

Creditor Name

Account Number

Loan Status

Monthly Payment

Interest Rate

%

Unpaid Balance

Type

Credit Limit

To be Paid off at or before closing

Maturity Date

Is their another mortgage or lien?

Yes No

Creditor Name

Account Number

Loan Status

Monthly Payment

Interest Rate

%

Unpaid Balance

Type

Credit Limit

To be Paid off at or before closing

Maturity Date

Financial Accounts & Securities

Account Type

Name of Institution

Account Titled As

Account Number

Balance/Value

$

Description

Pledged (Held AS Collateral)

Yes No

Add Additional Account(s)

Liabilities

Alimony Payments

$

Child Support Payments

$

Separate Maintenance Payments

$

Job Related Expense (Child Care, union Dues, Etc).

$

Other Payments

$

Owed To

Other Liabilities and Expenses

Other Liabilities and Expenses : 1

Account Type

Name & Address of Company

Monthly Payment

Months left to Pay

Unpaid Balance

Paid off at or before closing?

Account No

Add Other Liabilities and Expenses

Creditors / Liabilities (Non-Real Estate)

Creditor/Company Name

Address

Phone

Account #

Account is

Open Closed

Account Status

Current Delinquent

How is it Secured? (if Applicable)

Liability Status

Type

Account Description

Rate %

%

Min Payment $

$

Months Behind

Months Left to Pay

Original Balance

Account Balance $

$

Pay at/before Closing?

Yes No

Open/Origination Date

Maturity Date

Notes

Creditor Details

Representative

Address

City

State

Zip

Phone Number

Creditor Fax

Email

Notes

Collection Agency Details

Collection Agency Name

Representative

Address

City

State

Zip

Phone Number

AgencyFax

Email

Notes

Sum Totals

Total Liabilities

$

Total Monthly Payments

$

Add More Creditors/Liabilities

Partnerships

Partnerships 1

Type of Investment

Date of Initial Investment

Cost

$

Percent Owned

%

Current Market Value

$

Balance Due on Partnership: Holds, Cash, Call

$

Final Contribution Date

Add New Partnerships

Other New Mortgage Loans on the Property

Other New Mortgage Loans : 1

Creditor Name

Lien Type

Monthly Payment

$

Loan Amount/ Amount to be Drawn

$

Credit Limit

$

Add Other New Mortgage Loans

Loan Terms

Refinance Current Mortgage

Refinance Current Mortgage 1

Lien Number

Pay-Off Amount

$

Original Purchase Date

Current Lender

Original Purchase Price

$

Maturity Date of Loan

Pre-Payment Penalty $

$

Pre-Payment Penalty %

%

Cost of Improvements made

$

Are taxes and insurance included in the payment?

Yes No

Monthly Payment

$

Current Rate

%

Yes No

Current Loan Balance

$

Original Loan Balance

$

Add New Mortgage

Is this loan being cross collateralized?

Yes No

Subject Property Cash Flow (Annualized)

Income Info

Residential Gross Potential Income

$

Residential Calculate from Rent Roll?

Vacancy

$

Vacancy Rate

%

Commercial Gross Potential Income

$

Commercial Calculate from Rent Roll?

Vacancy Commercial

$

Commercial Vacancy Rate

%

Other Income (Laundry,Parking,Other)

$

Vacancy Other Income

$

Other Income Vacancy Rate

%

Tenant Contributions

$

Vacancy Tenant Contributions

$

Tenant Contributions Vacancy Rate

%

Effective Gross Income

$

Expense Info

Annual Property Tax

$

Annual Insurance Policy Premium

$

HOA Fees

$

Operating Expenses

$

Water / Sewer

$

Electricity

$

Gas

$

Repairs/Maintenance

$

Legal

$

Payroll

$

Misc.

$

Common Area Utilities

$

Elevator Maintenance

$

Replacement Reserves

$

Tenant Reimbursements

$

Management Expense

$

%

Net Operating Income

$

Cap Rate

%

Reserves

$ 0.00

Reserve Factor

$

Debt Service Ratio

Cash Available To Service Debt

$

Debt Service Ratio - PITIA

0.00

Gross Annual Rent of Largest Tenant

$

Seller Info

First Name

Last Name

Email

Phone

Address

City

State

Zip

Property Valuation

Appraiser Info

Appraiser Company 1

Upload Appraisal

Phone

Email

Appraiser First Name

Appraiser Last Name

As Is Value

$

Rehabbed Value

$

Monthly Rent

$

Date Obtained

Order Date

Appraiser Company 2

Upload Appraisal

Phone

Email

Appraiser First Name

Appraiser Last Name

As Is Value

$

Rehabbed Value

$

Monthly Rent

$

Date Obtained

Order Date

BPO Info

BPO1 - First Name

BPO1 - Last Name

Upload BPO

As Is Value

$

Rehabbed Value

$

Date Obtained

BPO Expiration Date

As Is Value

$

Rehabbed Value

$

Date Obtained

BPO Expiration Date

BPO3 - First Name

BPO3 - Last Name

As Is Value

$

Rehabbed Value

$

Date Obtained

BPO Expiration Date

Monthly Rent (12 months)

$

Monthly Rent (18 months)

$

Monthly Rent (24 months)

$

Internal Assessed Value

Cost Basis / Purchase Price

$

30 Day Quick Sale Value

$

Property value(As-is)

$

Zillow Value

$

Zillow Rent Value

$

Assessed Monthly Rent

$

Valuation Notes

Required Valuation Methods

HOA Information

Does the borrower pay a Condominium or HOA fee?

Are HOA fees paid current?

Monthly HOA fees

$

Delinquency Total?

$

Contact Name

HOA Company Name

Address

City

State

Zip

Contact Phone #

Fax #

Email

Does HOA allow Rentals?

Is Community 55+?

Notes fffffff

Is there a Master/Secondary HOA/COA?

Amount

$

Contact Name

HOA Company Name

Address

Email

City

State

Zip

Notes

Lender Information

Lender Name

Lender Last Name

Lender Firm Name

Lender E-mail

Address

City

State

Zip

State Of Formation

Entity Type

Phone #

Toll Free

Fax

Cell

EIN #

Rep Title

Estimated Project Cost/Use Of Funds Breakdown

Land Acquisition

$

New Building Construction

$

Construction Contingency (5-10%)

$

Business Acquisition

$

Land and Business Acquisition

$

Building or Leasehold Improvements/Repairs/Renovations

$

Acquisition of Machinery/Equipment

$

Acquisition of Furniture/Fixtures

$

Inventory Purchase

$

Working Capital (including Accounts Payable)

$

Refinancing existing business debt

$

Franchise Fee

$

Closing Cost(around 5% of loan amount)

$

Other Cost

$

Other Cost 2

$

total estimated project cost

$

LESS OWNER'S EQUITY TO BE INJECTED

$

LESS SELLER CARRY-BACK (If Applicable)

$

total loan requested for project

$

Collateral

Select all collateral available to support the loan

Inventory

Used Equipment/Machinery

Accounts Receivable

New Equipment/Machinery

Other

Detailed description of collateral

VENDOR & EQUIPMENT INFORMATION

1 ) Vendor Name

Vendor Phone

Vendor Contact

Equipment Type

Vin or Serial Number

Year

Sale Price

New Used

Make

Model

Quantity

Mileage

Equipment Description

Options

Pictures of Property

Select file to upload

Add Pictures Property

Foreclosure / Default Info

Has the borrower been 30+ days late in the past 12 months ?

Yes No NA

Is the mortgage currently behind?

Yes No NA

Has the borrower received a notice of foreclosure or default by the bank, attorney, or trustee?

Yes No NA

Type / Select the date Notice of Default received

Has client received notice of summons?

Yes No NA

Type / Select the date Notice of summons received

Type / Select Sales Date if provided by bank/attorney/trustee

Create a reminder for this sale date?

Trustee Sale #

Jurisdiction

Index #

Attorney Information

First Name

Last Name

Firm Name

Email

Phone

Fax

Cell

Address

City

State

Zip

Trustee Information

First Name

Last Name

Firm Name

Email

Phone

Fax

Cell

Address

City

State

Zip

Notes

Loan Workout Q & A

Do you want to keep the property?

Yes No NA

Have you applied for a loan modification?

Yes No NA

Date of application

Date of modification

Please provide all details

Has the borrower filed for bankruptcy?

Yes No NA

Is the borrower behind on plan payments?

Yes No NA

Filing Date

What is the Bankruptcy disposition status?

Bankruptcy Case number

Date discharged

Was the mortgage debt reaffirmed?

Yes No NA

Are the property(s) included in the bankruptcy?

Yes No NA

Is this home currently listed for sale?

Yes No NA

For how long?

For Sale by Owner?

Yes No NA

Listing Realtor Name

Real Estate Agency

Listing Phone

Listing price

$

Listing Date

Has the borrower received an offer on the property?

Yes No NA

Date of offer

Amount of offer

$

Does the borrower have more than one property?

Yes No NA

How many properties?

How many mortgages?

Are the property taxes currently delinquent?

Yes No NA

Delinquent tax total?

$

Which year(s) are delinquent?

Additional Questions

Any significant changes in the next 12 months?

Yes No

Please Describe

Title Info

Current Name on Title

New Name on Title

Estate will be held in

Recording #

Title Order Number

Title Report Date

Borrower Vesting Information

Title Report

Title Info : 1

Title Rep First Name

Title Rep Last Name

Title Company

E-mail

Phone #

Cell

Fax

Toll Free

Title Address

Title City

Title State

Title Zip

Title Notes

Add Title Info

Attorney Info

Attorney Info : 1

Attorney Name

Attorney Firm Name

Bar #

Attorney Phone

Attorney E-mail

Attorney Address

Attorney City

Attorney State

Attorney Zip

Add Attorney Info

Escrow Info

Escrow Info : 1

Escrow Rep First Name

Escrow Rep Last Name

Company

E-mail

Phone #

Toll Free

Fax

Cell

Escrow #

Escrow Address

Escrow City

Escrow State

Escrow Zip

Add Escrow Info

Financial Advisor

Financial Advisor : 1

First Name

Last Name

Name Of Company

Email

Phone

City

State

Zip

Website

Financial Advisor Notes

Add Financial Advisor

Accountant Info

Accountant : 1

First Name

Last Name

Name Of Company

Email

Phone

Address

City

State

Zip

Website

Notes

Add Accountant

Credit Memo

Billing/Payment Information

Check

Account and Bank Info

Checking ACT Bank Name:

Checking ACT Holder\'s Name on Account

Same as Mailing Address?

ACT Holders Address of Record with Bank

ACT Holders City

State

Zip

9 Digit Bank Routing Number

Checking ACT Number

Deposit Date

Account Type

Personal Checking Personal Savings Business Checking

Credit Card

Credit Card info

Type of Card

Card #

Exp Date

Card Holders Name on Card

CVV #

Same as Mailing Address?

Card Holders Address

ACT Holders City:

State

Zip

maxAmtToPutDownClass Acquisition Down Payment $ commercialTdFieldsClass Down Payment %	transactionalTdFieldsClass Initial Loan Amount $
rehabConsClsClass LTV%	LOCTotalLoanAmt_dispClass Initial Loan Amount $
doesPropertyNeedRehabDispDivCLass1 Rehab/Construction Cost $ doesPropertyNeedRehabDispDivClass2 Rehab/Construction % Financed	doesPropertyNeedRehabDispDivClass3 Rehab/Construction Cost Financed $
haveInterestreserveClass Do you want to Finance Pre-paid Interest Reserve? Yes No	2 haveInterestreserveDivClass Pre-paid Interest Reserve $ Months #
propertyNeedRehabinitialTddispClass Initial Draw Amount $	payOffMortgage1_dispClass Pay-Off on Mortgage 1 $ Pay-Off on Mortgage 2 $ Pay Off Oustanding Taxes $ Closing Costs Financed $
Total Draws Funded $	propertyNeedRehabinitialTddispClass Current Loan Balance $
	CORTotalLoanAmt_disp Total Loan Amount $
	Total Cash Out $
	Total Loan Amount $
Auto-calc Total Loan Amount based on ? ARV LTC NA	Total Project Cost $
	Total project soft & hard cost $

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Admin Info

Property Management

Tell us more about the deal, your background & why you need this loan?

Borrower Info

Co-borrower Information

Business Entity

Sales Method

Fee Schedule

Equipment Info

Additional Guarantors

HMDA - (Borrower)

HMDA - (Co-Borrower)

Borrower Background

Co-borrower Background

Borrower Experience

Typical Transactions

Co-borrower Experience

Property Management

SBA Questions

Other Business/Affiliate Information

Assets (Include Borrower + Co-borrower amounts if any)

Total:

$

$

Total Est. Value

- Total Amt Owed

= Total Net Worth

$

- $

= $

Gifts or Grants

Gifts Or Grants : 1

Contingent Liabilities

Contingent Liabilities 1

Schedule of Real Estate Owned and Sold

Schedule of Real Estate Info : 1

Borrower Employment Information

Additional Employment Information

Additional Employment Information : 1

Co-borrower Employment Information

Additional Employment Information

Additional Employment Information : 1

Borrower Monthly Income

$

Co-borrower Monthly Income

$

$

Borrower Monthly Expenses

Monthly Payment

Bal Owed

$

$

$

$

$

$

Co-borrower Monthly Expenses

Monthly Payment

Bal Owed

$

$

Financial Accounts & Securities

Liabilities

Other Liabilities and Expenses

Other Liabilities and Expenses : 1

Creditors / Liabilities (Non-Real Estate)

Partnerships

Partnerships 1

Other New Mortgage Loans on the Property

Other New Mortgage Loans : 1

Loan Terms

$

Simple ARV %

Full ARV %

Acquisition LTV %

Market LTV %

Loan-to-Cost(LTC) - Total Loan Amount %

% Of Rehab/Construction (Cost Financed) %

LTC w/Soft & Hard Cost %

% Of Rehab/Construction
(Cost Financed) %